Autosomal recessive polycystic kidney disease (ARPKD) is an important renal cause of death in the perinatal period and of childhood renal failure. Neonatal disease presentation is typical, and characterized by greatly enlarged kidneys due to fusiform dilation of collecting ducts; congenital hepatic fibrosis is often a major complication in older patients. Progress toward understanding this complex disorder has recently been made by the identification of the disease-causing gene, PKHD1, in chromosome region 6p12. PKHD1 is a very large gene (˜470 kb) containing 67 exons and an open reading frame (ORF) of 12,222 bp. PKHD1 has a tissue-specific expression pattern with the highest levels in fetal and adult kidney and lower levels in liver, pancreas and lung. The murine ortholog, Pkhd1, has recently been described.
A notable feature of both the human and murine genes is that multiple different splice forms may be generated. Visualization of PKHD1 transcripts by northern analysis has proved difficult with a smear of products often detected. These may represent multiple splice forms, unusual sensitivity of this transcript to degradation, or a combination of these factors. In situ hybridization of the murine transcript showed expression in the developing kidney and mature collecting ducts, plus ductal plate and bile ducts in the liver. Other sites of expression during development detected by in situ analysis were: large vessels, testis, sympathetic ganglia, pancreas and trachea with evidence that some sites of expression may be of specific splice forms.
The PKHD1 encoded protein, fibrocystin, is large (4074 aa) and predicted to be an integral membrane protein with a large extracellular region and a short cytoplasmic tail. Fibrocystin is not closely related to any other characterized protein, although it contains multiple copies of a defined domain and has regions of homology to other proteins; it seems to represent the founder member of a new protein family. The only well characterized domain in fibrocystin is the TIG/IPT (immunoglobulin-like fold shared by plexins and transcription factors) that is also found in the hepatocyte growth factor receptor (HGFR), plexins and other receptor molecules. Although fibrocystin has many more copies of this domain than these other proteins, the presence of the TIG domain, along with the structure of the protein, suggested that it may also act as a receptor.